Cost Conundrum - What a Texas town can teach us about health care

The Cost Conundrum by Atul Gawande from The New Yorker, Annals of Medicine, June 1 , 2009. "The primary cause of McAllen's extreme costs was, very simply, the across-the-board overuse of medicine. This is a disturbing and perhaps surprising diagnosis. Americans like to believe that, with most things, more is better. But research suggests that where medicine is concerned it may actually be worse.

A few doctors took profit growth to be a legitimate ethic in the practice of medicine. Not all the doctors accepted this. But they failed to discourage those who did. So here, along the banks of the Rio Grande, in the Square Dance Capital of the World, a medical community came to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers."

Some of the studies cited by Gawande appeared in Health Affairs.